The maxillary sinuses are located right behind the cheekbones. These are the sinuses where an infection usually occurs. The maxillary sinuses drain into the nose below the corners of the eyes. This section of the nose is known as the osteomeatal complex.
For some reason, when this part of the nose is blocked, the sinuses cannot drain properly and hence infection develops. Many times, the sinus opening itself gets blocked. The procedure done to clear the sinus opening is known as a Maxillary Antrostomy. The procedure done to clear the osteomeatal complex is known as Uncinectomy. Both these procedures are usually done together.
Sometimes, in very rare cases, the maxillary antrostomy done does not help fix the problem. The maxillary sinus is not able to drain completely or may have diseased tissue which cannot be removed in this way. The surgeon may then suggest a Caldwell-Luc procedure. In this procedure a new drainage pathway may have to be created between the maxillary sinus and the nose.
Surgery for chronic sinusitis is usually done for those patients who have not been able to respond to medication. A CT scan is usually done to confirm chronic sinusitis.
General anesthesia is administered to the patient. After the patient is asleep, the ENT surgeon passes a narrow tube called as the endoscope into the nose. The endoscope has a small camera along with a light attached to its end. This gives the surgeon a good view of the maxillary sinus, the opening and the area of the nose where it drains out. Small surgical instruments are now passed through another tube to the problem area.
The surgeon uses these instruments to remove the blockages present in the maxillary sinus. This helps the fluid present in the maxillary sinuses to drain effectively. Thus, the chances of getting another sinus infection is greatly reduced.
As associated with any surgery, there are some risks involved:
The patient is shifted to the recovery room soon after the surgery and is monitored for about an hour to check if there are any complications that arise. If everything is normal, you may be discharged on the same day. There will be specific instructions given to take care of the nose and sinus. You may also be given medications for pain.